Relationship Between Masked Hypertension Measured by Ambulatory Blood Pressure Monitoring and Left Ventricular Global Longitudinal Strain: A Retrospective Study

Fu, Ming; Hu, Xiangming; Sun, Shuhong; Yi, Shixin; Zhang, Ying; Feng, Yingqing; Zhou, Yingling; Geng, Qingshan; Dong, Haojian

doi:10.2147/ijgm.s310414

Cited by 3 publications

(5 citation statements)

References 30 publications

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“…There was statistically significant difference between two studied groups regarding GLS: (p value 0.001). This came in accordance with Fu et al [16] who showed that GLS was lower ('worse') in the prehypertensive group being compared with the normotensive group (202).…”

Section: Discussionsupporting

confidence: 91%

Left Ventricular Geometry and Function in Patients with Gray Zone Hypertension

Elshabrawy

Allaithy²,

Elsaidy³

et al. 2023

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Background: Hypertension is considered as the silent killer of human because the hypertensive patient may be not aware that he has hypertension and death can occur at any time without the reason being known. We aim to study the effect of gray zone hypertension [SBP from 120-139] and or [DBP from 80-89] which was classified as prehypertension under JNC-7 on the structure, geometry, and operation of the left ventricle using echocardiography Methods: This study included 100 patients who asymptomatic apparent healthy subjects visited cardiology outpatient department (OPD) for routine checkup. Patients were grouped into two equal groups: Group A whose blood pressure was in the gray zone hypertension [SBP from 120-139] and or [DBP from 80-89], and group B with SBP <120 mmHg & DBP <80 mmHg. Results: The two groups being studied were statistically significant different as regard LV geometrical pattern (p=0.028). They were also statistically significant in LV geometrical pattern between the males and females (p<0.05). The two groups were statistically significant different regarding GLS (p =0.001). Conclusions: Gray zone hypertension affects ventricular diastolic function and LV geometry, although systolic function was normal; GLS showed that subclinical LV dysfunction can occur.

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Section: Discussionsupporting

confidence: 91%

Left Ventricular Geometry and Function in Patients with Gray Zone Hypertension

Elshabrawy

Allaithy²,

Elsaidy³

et al. 2023

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“…Demographic and clinical characteristics of normotensive (reported in Table 2, Supplemental Digital Content, http://links.lww.com/HJH/C114) and MH participants were similar in four out of six studies. In the remaining two reports, individuals with MH were more likely to be overweight/obese [21,22] and older [22] than their normotensive counterparts.…”

Section: Resultsmentioning

confidence: 97%

“…GLS); the remaining 20 ones were review, commentary, editorial articles and case report. Thus, a total of six studies including participants with MH and containing sufficient clinical and cardiac imaging data (namely GLS), were included in the final review [18][19][20][21][22][23] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Out-of-office hypertension was differently defined among the various studies, referring to average 24-h BP (≥130/80 mmHg), daytime (≥135/85 mmHg), both periods, or 24-h, daytime and night-time BP (≥120/70 mmHg). Office and ABPM thresholds >95% percentile for age and height were used in adolescent individuals [22].…”

Section: Resultsmentioning

confidence: 99%

“…As expected, in MH individuals mean 24-h systolic/diastolic BPs were significantly higher than the corresponding office systolic/diastolic BPs (data provided by four studies). Two studies included individuals from community-based cohorts [21,22] while the other four studies were conducted in heterogeneous settings such as individuals with exaggerated response to exercise [18], athletes [19], patients referred for suspected hypertension [20], patients with primary obesity [22]. In all studies, treatment with antihypertensive drugs was an exclusion criterion.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Unmasking left ventricular systolic dysfunction in masked hypertension: looking at myocardial strain. A review and meta-analysis

Cuspidi

Gherbesi

Faggiano

et al. 2022

Journal of Hypertension

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Background and Aim:A growing body of evidence supports the view that masked hypertension (MH) (i.e. normal office and elevated out-of-office BP) is a blood pressure (BP) phenotype associated with increased risk of subclinical organ damage, cardiovascular disease and death as compared to true normotension. Whether left ventricular (LV) systolic function is impaired in individuals with MH is still a poorly defined topic. Therefore, we aimed to provide a new piece of information on LV systolic dysfunction in the untreated MH setting, focusing on speckle tracking echocardiography (STE) studies investigating LV global longitudinal strain (GLS), a more sensitive index of systolic function than conventional LV ejection fraction (LVEF).Methods:A computerized search was performed using Pub-Med, OVID, EMBASE and Cochrane library databases from inception until June 30, 2022. Full articles reporting data on LV GLS in MH, as assessed by ambulatory BP monitoring (ABPM), and normotensive controls were considered suitable for the purposes of review and meta-analysis.Results:A total of 329 untreated individuals with MH and 376 normotensive controls were included in six studies. While pooled average LVEF was not different between groups [64.5 ± 1.5 and 64.5 ± 1.3%, respectively, standard means difference (SMD): −0.002 ± 0.08, confidence interval (CI): 0.15/−0.15, P = 0.98), LV GLS was worse in MH patients than in normotensive counterparts (−18.5 ± 0.70 vs. −20.0 ± 0.34%, SMD: 0.68 ± 0.28, CI: 0.12/1.24, P < 0.01).Conclusions:Our findings suggest that early changes in LV systolic function not detectable by conventional echocardiography in the MH setting can be unmasked by STE and that its implementation of STE in current practice may improve the detection of subclinical organ damage of adverse prognostic significance.

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Predictors of Impaired Left Ventricular Global Longitudinal Strain in Patients with Essential Hypertension and Preserved Ejection Fraction

Noori¹,

Barzani²

2022

TOCMJ

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Background Early identification of hypertensive patients at risk of heart failure (HF) helps guide treatment intensification and predicting prognosis. Global longitudinal strain (GLS) derived from two-dimensional speckle-tracking echocardiography (STE) uncovers subclinical left ventricular (LV) systolic dysfunction (SLVSD) in patients with hypertension (HT) and preserved LV ejection fraction (PLVEF). STE is unavailable and/or underutilized in our locality for financial and technical reasons. Objectives We aim to identify clinical and echocardiographic parameters associated with and/or predictive of impaired GLS in hypertensive patients with PLVEF. Methods In this single-clinic, cross-sectional, observational study, 100 hypertensive patients with PLVEF were examined using conventional and 2D STE. Results The average GLS was found to be mildly reduced (-18.4 ± 2.2%) in the study group. Lower GLS (than -19%) was more common among patients with poorly controlled HT (Odds Ratio (OR)=9), being on multiple antihypertensive agents (OR=5), positive Sokolow-Lyon electrocardiographic criteria (OR=4.3), and obesity (OR=2). Conventional echocardiographic parameters predicting impaired GLS included: mitral annular plane systolic excursion (MAPSE) (p=0.001), inter-ventricular septal thickness (IVSd) (p=0.003), LV mass (p=0.003), and any LV remodelling (p=0.02). Aortic acceleration-to-ejection time ratio (AT/ET) had good correlation with GLS (p=0.034). The novel product (IVSd x AT/ET) ≥2.7 mm was found to be the best predictor of GLS worse than -19% (AU ROC=0.8, 95% CI [0.68-0.93]; p=0.001). Conclusion In hypertensive patients with PLVEF, GLS correlates well with blood pressure (BP) control, body size, measures of LV mass, and MAPSE. These parameters predict at least 50% of the variance in GLS, and could help practitioners with limited access to STE in risk stratifying hypertensive patients.

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Relationship Between Masked Hypertension Measured by Ambulatory Blood Pressure Monitoring and Left Ventricular Global Longitudinal Strain: A Retrospective Study

Cited by 3 publications

References 30 publications

Left Ventricular Geometry and Function in Patients with Gray Zone Hypertension

Left Ventricular Geometry and Function in Patients with Gray Zone Hypertension

Unmasking left ventricular systolic dysfunction in masked hypertension: looking at myocardial strain. A review and meta-analysis

Predictors of Impaired Left Ventricular Global Longitudinal Strain in Patients with Essential Hypertension and Preserved Ejection Fraction

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